First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China.
Tianjin Medical University General Hospital, Tianjin, 300052, China.
Brain Imaging Behav. 2022 Feb;16(1):31-42. doi: 10.1007/s11682-021-00474-z. Epub 2021 Apr 24.
This prospective study aimed to explore the white matter microstructural alterations in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) using the Tract-based Spatial Statistics (TBSS) method of diffusion kurtosis imaging (DKI).Diffusion images were collected from 45 AD patients, 42 aMCI patients, and 35 healthy controls (HC). The differences of DKI-derived parameters, including kurtosis fractional anisotropy (KFA), mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD), were compared across the three groups using the TBSS method. Correlation between the altered DKI-derived parameters and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were analyzed. A receiver operating characteristic curve (ROC) was used to evaluate the diagnostic performance of different white matter parameters with the strongest correlations. As a result, compared with the HC group, KFA values decreased significantly in the aMCI group. Compared with both the HC and aMCI groups, the FA, KFA, and MK values decreased significantly and the MD value increased significantly in the AD group. FA, MD, KFA, and MK values of many white matter fiber tracts were significantly correlated with MMSE and MoCA scores. The area under the ROC curve (AUC) for the splenium of corpus callosum KFA values were highest for the diagnosis of aMCI and AD patients. In conclusion, the compactness and complexity of white matter microstructures were reduced in AD and aMCI patients. DKI can provide information about the severity of AD progression, and KFA might be more sensitive for the detection of white matter microstructural alterations.
这项前瞻性研究旨在使用基于体素的各向异性分数张量(TBSS)方法的扩散峰度成像(DKI)探索阿尔茨海默病(AD)和遗忘型轻度认知障碍(aMCI)的白质微观结构改变。从 45 例 AD 患者、42 例 aMCI 患者和 35 名健康对照者(HC)中采集扩散图像。使用 TBSS 方法比较三组之间 DKI 衍生参数(包括峰度各向异性分数(KFA)、平均峰度(MK)、各向异性分数(FA)和平均扩散系数(MD))的差异。分析了改变的 DKI 衍生参数与简易精神状态检查(MMSE)和蒙特利尔认知评估(MoCA)评分之间的相关性。使用受试者工作特征曲线(ROC)评估具有最强相关性的不同白质参数的诊断性能。结果,与 HC 组相比,aMCI 组的 KFA 值显著降低。与 HC 和 aMCI 组相比,AD 组的 FA、KFA 和 MK 值显著降低,MD 值显著升高。许多白质纤维束的 FA、MD、KFA 和 MK 值与 MMSE 和 MoCA 评分显著相关。胼胝体压部 KFA 值的 ROC 曲线下面积(AUC)对 aMCI 和 AD 患者的诊断最高。总之,AD 和 aMCI 患者的白质微观结构的紧密性和复杂性降低。DKI 可以提供 AD 进展严重程度的信息,而 KFA 可能更敏感地检测白质微观结构改变。
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